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Table 4 Summary of key findings: implementation and practicality

From: Evaluation of the national policy of single screening and treatment for the prevention of malaria in pregnancy in two districts in Eastern Indonesia: health provider perceptions

Area Themes Sub-themes
Implementation   To what extent is SST being carried out in health facilities, and where?
  SST Pregnant women are being screened for malaria on their 1st ANC visit (regardless of symptoms); after the 1st visit, they will only be screened for malaria if they present with symptoms; SST is reportedly not being implemented at all or not consistently
  SST at health posts/village level Pregnant women are not being screened at health posts; only carried out at health posts if RDTs are available; pregnant women are told to go to health centres for screening; screening is being done at health posts using RDTs; in some village settings, only symptomatic women are being screened; challenges with implementation at village level: a) Limited RDT stocks or complete stock-outs; b) Lack of staff (trained staff, lab technicians)
  RDT availability RDTs have never been used; are not available/current stock outs for RDTs and previous stock outs across facilities/areas; RDTs expired before being used or facilities receiving RDTs close to expiry
  Anti-malarial prescription at different facility levels Anti-malarials not available at health posts; pregnant women must to go to health centres to receive treatment; treatment prescribed by a doctor; doctors and/or midwives provide pregnant women with prescription (at ANC); women collect anti-malarials from pharmacy; anti-malarials cannot be prescribed without confirmation from a diagnostic test for malaria
Practicality   To what extent is SST being carried out using existing resources?
  RDT vs microscopy Microscopy is main method of screening at health centres, or is used primarily but sometimes RDTs are used when the electricity is out or lab services are not available; when available RDTs are used for screening at health posts/sub health centres; RDTs are often administered by midwives, or lab technician (reported at one location); RDTs are not being used at health posts
  SST at different levels of health facility SST should be done at health posts as they are more accessible; SST at both health posts and health centres; at health centres as they have microscopes and staff; SST at all facilities is good if you have the resources; SST at home would be the best option
  DP for treatment DP is prescribed for treatment in 2nd and 3rd trimesters; DP stocks were mostly stable, but a few participants reported occasional stock outs; DP is well tolerated and effective; health provider concerns about completing doses of anti-malarials; DP has shorter dosing regimen than quinine, could be better for compliance